HK-1: COMPUTATION OF STATUTORY INCOME FROM …ecsoft88.com/ectsample1.pdf · F. ADJUSTMENT OF...

0608089893 GO

Reference No.

page - 1Working Sheet

3. TOTAL (D1 + D2)

2. Surplus recovered expenditure (mining)

TOTAL

Loss from investments

Foreign exchange loss

Loss on disposal of assets

1. Non-allowable losses:

ADD:

D. ADJUSTMENTS FOR BUSINESS INCOME

INCOME (A - B)

C. TOTAL BUSINESS

B. TOTAL NON-BUSINESS INCOME

Other income

Interest income

Royalty income

Rental income

Dividend income

SEPARATION OF INCOME ACCORDING TO CLASSLESS :

-+

A. BALANCE AS PER PROFIT AND LOSS ACCOUNT

Item

Business code

Type of business

Indicate "X" in the relevant

Year of Assessment

Amount

54321

Business

Business Registration No.

I.C. No.Tax

Name

HK-1: COMPUTATION OF STATUTORY INCOME FROM BUSINESS

0

0

0

0

0

0

0

0

0 100,000

0

021

woK hA

97

2

36368040700

102

5 67896

0

Tour operator activities

0

0

0

0

0 100,000

X

9

43

naT

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0 100,000

00

0

0

0

0

0


Medical

Seminars

Fees/Subcriptions (unrelated to business)

Telephones/Handphones

Household benefits

Use of motor-vehicle(s)

Travelling/Accommodation

1.16 Personal expenditure:

1.15 Assets written off

1.14 Restriction on EPF

1.13 Expenditure on interest

1.12 Legal fees

1.11 Capital expenditure

1.10 Initial/Termination of business expenditure

1.9 Provision for bad/doubtful debts

1.8 Cash drawings

1.7 Withdrawal of stock in trade for own use

1.6 Penalties/fines/compound

1.5 Donations

1.4 Gifts

1.3 Entertainment

1.2 Own salary, allowances, bonus, EPF

1.1 Depreciation

1. Non-allowable expenditure and charges

ADD:

F. ADJUSTMENT OF BUSINESS EXPENDITURE

(C + D5)

E. BUSINESS INCOME

5. TOTAL (D3 - D4)

TOTAL

Porfit from investments

Foreign exchange gain

Profit on disposal of assets

4. Non-taxable gains/income entered in the profit and loss account:

LESS:

0

(g)

(f)

(e)

(d)

(c)

(b)

(a)

0

0

0

0

0

0

100,000

0

100,000

0

100,000

0

100,000

00

0

0

0

6. Balance carried forward (K4 - K5)

(amount as per item J4)

If H - (Adjusted Loss), transfer this amount to item D1 HK-1.3 before proceeding to items

H. ADJUSTED LOSS (F6 - E)

OR

(F1 - F5)

5. TOTAL (F2 + F3 + F4)

4.3 ..........................................................

4.2 ..........................................................

4.1 ..........................................................

4. Further deductions:


5. Capital Allowance absorbed in the current year

LESS:

4. TOTAL (K1 + K2 + K3)

3. Capital Allowance

2. Balancing Allowance

ADD:

1. Balance brought forward

K. ADJUSTMENT OF THE BALANCE OF CAPITAL ALLOWANCE (if relevant)

0

5. STATUTORY INCOME (J3 - J4)

0

Capital Allowance absorbed4. LESS:

3. TOTAL (J1 + J2)

Balancing Charge2. ADD:

(Enter "0' in this box if there is adjusted loss for item H)

1. ADJUSTED INCOME

0

J. COMPUTATION OF STATUTORY INCOME

J and K for computing the balance of capital allowances to be carried forward

If G - (Adjusted Income), proceed to item J for further computation.

(Transfer this amount to item C1/C2/C3 Form B)

0

0

G. ADJUSTED INCOME (E + F6)

6. TOTAL ADJUSTED EXPENDITURE

(amount as per K4 but restricted to the amount in item J3)

3. Surplus residual expenditure (mining)

2. Mining allowance

LESS:

TOTAL (1.1 to 1.17)

1.17 Other expenditure (Specify .................................)

60,000

30,000

20,000

0

10,000

HK-1.2.4A

HK-1.2.3A

HK-1.2.2A

HK-1.2.1A

4. Plant and machinery

1. Qualifying agriculture expenditure

C. CURRENT YEAR CAPITAL ALLOWANCE

5. TOTAL

3. Indus trial building

2. Qualifying forest expenditure

0

0

0

0

0

0

0

0

HK-1.2.4A

HK-1.2.4A

HK-1.2.3A

HK-1.2.2A

HK-1.2.1A


3. TOTAL


B. BALANCING ALLOWANCE

HK-1.2.3A

5. TOTAL


A. BALANCING CHARGE Working Sheet


2. Qualifying forest expenditure

1. Qualifying agriculture expenditure

Name

Tax Reference No.


HK-1.2: SUMMARY OF CAPITAL ALLOWANCES

woK hA

2102

0608089

Year Of Assessment

893

(Transfer this amount to K3, HK-1/ Q3, HK-1C/ N3, HK-1D)

GO

(Transfer this amount to K2, HK-1/ Q2, HK-1C/ N2, HK-1D)

(Transfer this amount to J2, HK-1/ J2, HK-1C/ J2, HK-1D)

naT

Y* " "

(Proviso to paragraph 27 Schedule 3).

Value or

(ii)

NOTA:

(11M)

(11K + 11L)

(Transfer this amount to HK-1.2.1A)13 AGRICULTURE ALLOWANCE

AGRICULTURE CHARGE12

allowance

Accumu-

N

N

11

allowance

(Transfer this amount to HK-1.2.1A)

Agriculture

M

Date of

disposalexpenditure

Date of

Class

TOTAL

1

Item

A

10

N/Y

9

8

7

incurred

6

5

4

3

2

charge

Agriculturelated

(i)

woK hA na

210

Of Asset

060

Subsidyexpenditure

Grant/Residual

allowance

AnnualResidual

DescriptionexpenditureCost

%

Rateassess-

Year of

* where the agriculture charge is spread equally over the years of assessment for which the agriculture allowances were given

LKJHGFEDCB

ment

Agriculture charge on an asset which is disposed of within 6 years from the date on which the expenditure was incurred or deemed incurred, is :

is the number of years of assessment for which the agriculture allowances were given to the business.

c/fb/f

Name

Tax Reference

Year Of

No.

Assessment

HK-1.2.1: AGRICULTURE ALLOWANCES

O 8089893 G

T

2

10,000 10,00000 10,000 10,0000 Farm Road 20,000 50201202/08/2012B1c

10,0000

0

0

10,000

to C1, HK-1.2)to A1, HK-1.2)(Transfer this amount(Transfer this amount

Name

Tax Reference No.

Year Of Assessment


TOTAL

ATTACHMENT 5

ATTACHMENT 4

ATTACHMENT 3

ATTACHMENT 2

ATTACHMENT 1

Agriculture

ChargeAgriculture

Allowance

BA

HK-1.2.1A: SUMMARY OF AGRICULTURE ALLOWANCES

0608089893 GO

woK hA

2102

naT

20,000 10,000

20,000 10,000

Initial

allowancecompletion of




(11H + 11J)

(11N)

(11M)

INDUSTRIAL BUILDING ALLOWANCE

BALANCING ALLOWANCE

BALANCING CHARGE

14

13

12

11

10

Balancing

allowancecharge

Balancing

value

Disposalexpenditure

Residual

allowance

Annual

expenditure b/f

ResidualCost

%

Rate

Name

assessment

Year ofDate of

disposalpurchase/Date of

Class

NMLKJHG

c/f

FED

construction

TOTAL

1

Item

9

C

8

7

6

B

5

4

A

3

Of Asset

Description

HK-1.2.3: INDUSTRIAL BUILDING ALLOWANCES

2

Tax Reference No.

Year Of Assessment

page - 28

woK hA

Working Sheet

2102

0608089893 GO

naT

000 17,400 600 2,0000 Factory 20,000 3201208/08/2012D1a

2,600

0

0

00 600 2,000


TOTAL

ATTACHMENT 5

ATTACHMENT 4

ATTACHMENT 3

ATTACHMENT 2

ATTACHMENT 1

C

BuildingIndustrial

Allowance

B

BalancingBalancing

A

Charge Allowance

to item C3, HK-1.2)to item B1, HK-1.2)to item A3, HK-1.2)

(Transfer this amount(Transfer this amount (Transfer this amount


HK-1.2.3A: SUMMARY OF INDUSTRIAL BUILDING ALLOWANCES

woK hA

2102

0608089893

Name

Tax Reference No.

Year Of

G

Assessment

O

naT

30,000 20,000 10,000

30,000 20,000 10,000

small

Annual

Allowance on

allowance/

assets

valueb/f




(11J + 11K)

(11P)

(11N)

(M)at the date of disposal exceeds the disposal value(G)= Residual expenditures(G - M)Balancing allowance

at the date of disposal.(G)(M) exceeds the residual expenditure= Disposal value(M - G)Balancing charge

CAPITAL ALLOWANCE

BALANCING ALLOWANCE

BALANCING CHARGE

14

13

12

11

10

Balancing

allowancecharge

Balancing

value

Disposalexpenditure

Residual

allowance

Initial

payments

Instalmentexpenditure

Residue

c/fexpenditure

Qualifying

%

Rate

which qualifies

assessment

First year ofDate of

disposalpurchase

Date ofClass

PNMLKJHGFED

Reference No.

Note:

TOTAL

1

Item

9

C

8

7

6

B

5

4

A

3

Name

Tax

Year Of Assessment

HK-1.2.4: PLANT AND MACHINERY ALLOWANCES

2

Of Asset

Description

0

woK hA

6

2102

08089893 GO


naT

Machine 1 000 13,200 2,800 4,000 20,0000 20,000 14201206/08/2012E2a

6,800

0

0

00 2,800 4,000

TOTAL

ATTACHMENT 5

ATTACHMENT 4

ATTACHMENT 3

ATTACHMENT 2

ATTACHMENT 1

C

AllowanceCapital

Allowance

B

BalancingBalancing

A

Charge


HK-1.2.4A: SUMMARY OF PLANT AND MACHINERY ALLOWANCES

to item C4, HK-1.2)to item B2, HK-1.2)to item A4, HK-1.2)

(Transfer this amount(Transfer this amount (Transfer this amount

woK hA

2102

0608089893

Name

Tax Reference No.

Year Of

G

Assessment

O

naT

40,000 30,000 20,000

40,000 30,000 20,000

0608089893 GO

Date OfDate Of

Assessment

Class OfPaymentDisposalPurchaseDescription Of AssetAssetNo.

page - 34

woK hA

Working Sheet

2102

Name

Tax Reference No.

Year of

HK-1.2A: SUMMARY OF CAPITAL EXPENDITURE

Method Of

naT

Cash 05/08/2012Factory A D1a 1

Enter "X" in the relevant box.

Use attachment(s) if case of insufficient writing space.

( 1 to 5 )TOTAL

CHILD - DISABLED

( 1 to 5 )TOTAL

5

4

3

Higher Education

( 1 to 10 )TOTAL

CHILD - 18 YEARS OF AGE & ABOVE AND RECEIVING EDUCATION

CHILD - BELOW THE AGE OF 18 YEARS

HK-13: DEDUCTION FOR MAINTENANCE OF UNMARRIED CHILDREN

*

5

4

1

2

1

10

9

Claimed

3

Amount

ReliefRate *

Eligibility

50%100%

Higher Education

Level of Education at the Institution of

Outside MalaysiaIn Malaysia

2

Date Of Birth University / Institution Of

Name Of School / College /

Name Of Child

No.

No.

8

7

6

5

4

3

2

Name

Tax Reference

Year of Assessment

*

1

woK hA

2102

0608089893 GO

naT

1,000 XABC 08/01/2000Tan Ah fatt

1,000

page - Working Sheet

0

0

060808

Item Amount

Indicate "X" in the relevant box

Year of Assessment

54321

Business

9 I.C. No.Tax Reference No.

Name

HK-2: COMPUTATION OF STATUTORY INCOME FROM EMPLOYMENT

0

J. Travelling expenditure

G. Subscription to professional bodies

H. Entertainment expenditure (restricted - section 38A)

LESS:

E. Compensation for loss of employment [parapraph 13(1)(e)]

woK hA

or Society [paragraph 13(1)(d)]

(amount attributable to employer's contribution only)

2

36368040700

102

89

60,000

0

0

20,000

10,000

0

0

30,000

30,000

3

F. TOTAL GROSS EMPLOYMENT INCOME (A to E)

B. Benefits-in-kind [paragraph 13(1)(b)]

C. Benefit/Value of accommodation provided [paragraph 13(1)(c)]

2. Gratuity

D. Refund from unapproved Pension or Provident Fund, Scheme

3. Tax allowance/Tax borne by the employer

1. Money/Benefits or amenities convertible into money

A. Receipts under paragraph 13(1)(a)

G

X

9

4. TOTAL (A1 to A3)

O

37

naT

Working Sheet page - 38

60,000

0

0

60,000

60,000

0

0

0

0

0

0

0

4. TOTAL

3. Employment 3 (amount M from Employment 3)

2. Employment 2 (amount M from Employment 2)

1. Employment 1 (amount M from Emploment 1)

N. SUMMARY OF STATUTORY INCOME FROM EMPLOYMENT

M. Statutory Income From Employment (F - L)

L. TOTAL (G, H, J and K5)

[subsection 38(3)]

K1(c) or K4 whichever is lower

5. Deductible expenditure:

4. TOTAL PAYMENT (K2 + K3)

[paragraph 38(1)(b)]

and repairs/maintenance of the premise3. Quit rent, assessment, insurance premiums

by the employee [paragraph 38(1)(a)]

2. Rental of living acccommodation and furniture paid

(c) TOTAL [K1(a) + K1(b)]

[amount as per item C - subsection 32(2)]

(b) Value of living accommodation benefit

HK-2.4 - subsection 32(1)]

[amount as per total of item B Working Sheet

(a) Value of benefits/amenities related to the accommodation provided

1. Benefit of accommodation taken into account:

K. Expenditure related to the accommodation provided by the employer

0

name) exceeding 1 unit for each asset

0

39

0

0


0

0

0

Monthly bills for fixed line telephone, mobile phone, pager, PDA or subscription

Fixed line telephone, mobile phone, pager or personal digital assistant (PDA)

Allowances

Awards/Rewards

N.

M.

L.

K.

0

P. Recreational club membership paid/reimbursed by the employer

Transfer amount P to item A1 Working Sheet HK-2

the employee's name) exceeding 1 line for each asset

of broadband including cost of registration and installation (registered under

TOTAL (J - J4)

Subtotal (J1 + J2 + J3) (restricted to RM2,000)4.

80,000TOTAL (A to Q)R.

0

Other receiptsQ.

- term membership

- monthly/annual membership subscription fees for club membership, and

- entrance fee

(type of membership - individual)

including cost of registration and installation (registered under the employee's

0

Perquisites (cash/in kind)

Gross tips

Bonuses

Commissions

I.C. No.Tax Reference No.

Name

HK-2.1: RECEIPTS UNDER PARAGRAPH 13(1)(a)

Fees

0

Overtime pay

Leave pay

Wages

J.

H.

G.

0

Year of Assessment

service with the same employer)

F.

(* more than 10 years

long service * award 3.

0

0

0

woK hA

20,000

10,000

0

36368040700

0

0

productivity award

innovation award or

Service excellence award,

50,000

2.

past achievement award1.

in amount/value in respect of:-

Exemption limited to RM2,000

2102

E.

D.

0608089893 G

C.

Less:

MONEY/BENEFITS OR AMENITIES CONVERTIBLE INTO MONEY

O

A.

9

Item

B.

Gross salary/remuneration

Amount (RM)

naT

* Enter “X” in the relevant box

*XDivided into 6 (six) years

2. Method 2

daysNo. of complete days (D1) =

* Apportionment according to time

month(s) 7year(s) 4=

YearMonthDay

to021

022113

010 80

YearMonthDaycontinuous service

Year

40

basis


2012 8,3331/6 x 500001 year2012

2011 8,3331/6 x 500001 year2011

2010 8,333

Month

1/6 x 500001 year2010

2009 8,3331/6 x 500001 year2009

2008 8,3331/6 x 500001 year2008

2007

Year Of Assessment

8,3331/6 x 500001 year2007

F. Transfer the amount from item E4(vi) for the current year of assessment to item A2 Working Sheet HK-2.

(vi)

(v)

(iv)


Name

HK-2.2: COMPUTATION OF TAXABLE GRATUITY

Day

50,000

027013 21

2

(iii)

(ii)

(i)

1

Assessment

Year Of

5

woK hA

RM

Amount

2

36368040700

102

4

Computation

0608089893

3

(days/years)

Period

2

Apportionment

1

1. Method 1

D. Basis of apportionment :

C. Length of

B. Date of payment

9GO

E. Apportionment of gratuity according to Year of Assessment

A. Total gratuity RM

naT

2102

1102

No.Business Registration No.

I.C. No.Tax Reference

Name

HK-2.3: COMPUTATION OF TAX ALLOWANCE

woK hA

363680407009

Aassessment indicated in item . Use one row for each year of assessment.

C6C2Use rows to for additional taxes of preceding years of assessment raised in the basis period for the year of

BC1Use row for the year of assessment indicated in item .

A

C

assessment indicated in item .

5.

Aof assessment indicated in item , even though the tax has not yet been paid by the employer.

Use the boxes in item to compute the total of all tax allowances which shall be taken into account for the current year of

4. Additional tax is taken into account as a tax allowance if the notice of assessment is issued in the basis period for the year

n

A

B

aT

Tax for the preceding year of assessment indicated in item is to be taken into account as a benefit for the year of3.

This benefit is a type of income under paragraph 13(1)(a) ITA 1967.

benefit of tax borne/paid byTax allowance is an income chargeable on the employee who receives the his employer.1.

Reminder :

(Transfer amount C7 to item A3 Working Sheet HK-2)

Total [ C1 to C6 ]7

6

5

2.

4

3

2

5

1

Amount Of Tax/Additional Tax (RM)Date Of Notice Of Assessment

A. Year Of Assessment

Year Of AssessmentNo.

6789643

C. Tax Allowance

0608089893 GO

41

B. Preceding Year Of Assessment


assessment indicated in item , even if the tax has not been paid by the employer.

1,000.0006/08/20122012

1,000.00

0

0

0

0

0

2,000

fees for club membership (type of membership: corporate)

42

G. Monthly/Annual recreational club membership subscription

0


F. Household servants 0

installation (registered under the employee's name) exceeding

D. Monthly bills for fixed line telephone, mobile phone, pager, PDA

assistant (PDA) including cost of registration and installation

1,000

0

C. Fixed line telephone, mobile phone, pager or personal digital

J. Other benefits

E. Gradeners

or subscription of broadband including cost of registration and

9,000(Transfer this amount to item B Working Sheet HK-2)

0

K. TOTAL (A to J)

060808

Year of Assessment

9893 I.C. No.Tax Reference No.

Name

HK-2.4: BENEFITS-IN-KIND (BIK) [PARAGRAPH 13(1)(b)]

0

0

0

G

3,000

0

1,000

BENEFITS-IN-KIND (BIK)

woK hA

H. Leave passages

(4) Service charges and other bills such as water and electricity

2

36368040700

102

O

2,000

one or more of kitchen equipment, crokery, utensils and

(3) Fully-furnished with benefits as in items B(1) and B(2) plus

or more of air-conditioners, curtains and alike; and carpets

(2) Semi-furnished with furniture as in item B(1) and one

bedrooms(1) Semi-furnished with furniture in the lounge, dining room, or

B. Value of household benefits

(2) Value of driver

(1) Value of motorcars and petrol

A. Motocars

Item

9

1 line for each asset

(registered under the employer's name) exceeding 1 unit for each asset

appliances

Amount (RM)

naT

43

1,000


Month(s)

Month(s)

(m)

(n)

2. 3% of G (G x 3/100)

H. 1. 30% of G (G x 30/100)

G. Receipts under paragraph 13(1)(a)

F. Defined value (rental per month x m)

E. Length of employment in the current year

D. Period for which the accommodation is provided

Y is the accomodation provided as a whole

Share of living

(X) (Y)

X is your share of the accommodation provided.

Share of living3. Partly used for advancing

2. Shared

1. Not shared

C. SHARE OF ACCOMMODATION*

Year of Assessment

2. Hotel, hostel or similar premise; any premise on a plantation or in the forest; or any premise

1. Ordinary residential premise

B. TYPE OF ACCOMMODATION*

2. Director of a controlled company


Name

HK-2.5: VALUE OF LIVING ACCOMMODATION BENEFIT [PARAGRAPH 13(1)(c)]

0608089

1. Employee (other than officer of a qovernment/statutory body) or service director

893

accommodation

X

(Y)accommodation

the interest of the employer

woK hA

which, although in a rateble area, is not subject to public rates

2

36368040700

102

(X)

300TOTAL (G1 - G2)3.

0any right to acquire shares in a company

Amount from item A4 Working Sheet HK-2

Gross income from perquisite in respect of2.

Less:

9

GO

12

12

00

00

X

90

A. JOB STATUS *

X

300

9

* Enter "X" in the relevant box.

1.

naT

(Enter "0" if amount is negative)

Value of accommodation Z





0

0

0

90

0

0

Amount

Amount

Living accommodation of type B1 and the share of living accommodation is C2.3.2

Living accommodation of type B1 and the share of living accommodation is C1.

F x X/Y x n/m

44

F x n/m

Amount

A director of a controlled company provided with:

Amount H1 or F x X/Y (whichever is lower) x n/m

3. Director of a controlled company

Amount H1 or F (whichever is lower) x n/m

2.1

An employee (other than officer of a government/statutory body) or a service director provided with:

3.1

(Transfer amount Z to item C Working Sheet HK-2)





Amount H1 or F x X/Y (whichever is lower) x n/m



H2 x n/m


Living accommodation of type B1 and the share of living accommodation is C1.

page -

An employee (other than officer of a government/statutory body) or a service director provided with living

1. Employee (other than officer of a government/statutory body) or service director



Employee (other than officer of a government/statutory body) or service director


2.

accommodation of type B2

J. VALUE OF LIVING ACCOMMODATION BENEFIT SUBJECT TO TAX


Transfer amount Z to item C Working Sheet HK-2


Working Sheet

RM

RM

No. of completed years

Example 2:

RM10,000 x 5 = RM50, 000

05 years

01.01.2006

5 years 7 months 15 days

15.07.2011

06

021030

08089893 GO

00

46

00


2

0000


6

0000

Year of Assessment

8

6


Name

HK-2.7: COMPUTATION OF TAXABLE COMPENSATION

RM6,000 x 8 = RM48, 000

028010 21

6

Example 2:

08 years

0

04 years

Amount of exempted compensation

woK hA

Length of service

2

36368040700

102

(Transfer amount D to item E Working Sheet HK-2)

01.06.1999

8 years 7 months 15 days

15.01.2008

RM6,000 x 4 = RM24, 000

4 years 4 months

30.06.200801.03.2004


D. Taxable compensation (B-C)

Date of cessation

Date of commencement



Length of service

Length of service

Date of cessation


Example 1:

C. Amount of exempted compensation

* Examples on computation of completed years and the amount of exempted compensation:

B. Amount of compensation

3. No. of completed years of service*

2. Date of cessation

1. Date of commencement

RM

9

Date of cessation


Year(s)

A. Length of service with the same employer or companies in the same group

naT

Year of Assessment

5 Business Registration No.


Name

678964

No.

woK hA

36368040700

3

0608089893

2102

9GO

HK-3: TAX DEDUCTION UNDER SECTION 51 OF FINANCE ACT 2007 (DIVIDENDS)

naT

Submit this Working Sheet and original dividend vouchers if entitled to a tax refund (Use separate HK-3 for dividends regrossed)

DividendNet

Sen

DeductedTax

Name of CompanyWarrant No. /

Payment

Date of

Serial No.

A. List of dividend income:

Gross

RateSen

Tax

RMRM

No.

Y [amount from B(ii)]

15

14

Note: Proceed with the computation overleaf if the rate of tax deducted on dividend received as per voucher / certificate differs from the tax rate for current year of assessment

X [amount from B(i)]

Total Regrossed

TOTAL NET DIVIDEND

10

9

8

7

6

Dividend

5

Sen

4

3

2

EndedRM

1

13

12

11

For Year

00 25.0000456456 750 250 1000ABC 01/08/2012 00

31/12/2012

00 750

Tax deduction under section 51 of Finance Act 2007

Statutory Income

250.00

1,000.00

(Transfer this amount to item E10 Form BE/B)

(dividends) (as per amount Y above)D.

(Transfer amount (iii) to item C2 Form BE / C11 Form B)

(iii)

Interest on loan employed in the

Computation Of Statutory Income From Dividends

Computation of regrossed dividend and tax deemed deducted

Gross Dividend (X)

(1-Z*)

1X

Net dividend

=

(Y)=

Z*X X =

Tax deemed deducted (Y)

= Net dividend

(1-Z*)

(X)

Dividend regrossed (X)

If the rate of tax deducted as per dividend voucher/certificate differs from the current year's tax rate for

* Where Z is the current year's tax rate for corporations.

(ii)

=

(i)

deemed deducted :-

corporations, please use the following formula to regross the net dividend received and compute the tax

-

1000.00

B.

(ii)

Less:

(i)

C.

production of gross dividend income

0608089893 GO

Lease Payments

Lease

Asset

No.

Of The Rental/

49page - Working Sheet

1,00001/01/2012

1, Jalan One Taman Two 57000 KL

Apartmrnt

7

8

refer to plant, machineries, furniture and other than those mentioned above.Assets2.

refer to houses, factories, land and other immovable properties.Properties1.

Year of Assessment



Name

HK-4: PARTICULARS OF PROPERTIES / ASSETS AND TOTAL RENTAL

woK hA

2

36368040700

102

5 67896

9

43

naT

Note:

9

10

2

3

4

5

6

1

Address Of The Property /

Total Gross Rental/Date Of

Lessor Of The Asset

Type Of Property/ Commencement

A. LIST OF PROPERTIES RENTED / ASSETS LEASED

Of Assessment (RM)

No. Received In The Year


...........................................

.................................................

.................................................

.................................................

.................................................

.................................................

.................................................

.................................................

.................................................

.................................................

(Transfer the total statutory income from rent to item C4 Form BE / C13 Form B)

rents received from partnership business

Total statutory income from rents including

Source 1 (Amount from item C)

D. SUMMARY OF STATUTORY INCOME FROM RENTS

C. STATUTORY INCOME FROM RENTS (B1 - B2)

2. Total Expenditure (i to vi)

vi. Renewal of tenancy agreement

v. Repairs and maintenance

iv. Insurance

ii. Assessment

rental incomeof gross

in the production

iii. Quit rent


LESS: Allowable Expenditure

i. Interest on loan employed

1. GROSS RENTAL INCOME (From item A1 or A2 or A3 .... A10)

(Compute separately for each source of rental income)

B. COMPUTATION OF STATUTORY INCOME FROM RENTS

Other revenue expenditure



1,000

5 6789No.

900

900

100

1,000

(F + G)H. TOTAL STATUTORY INCOME FROM ROYALTIES

(Amount from item D Working Sheet HK-6/

G. Total Gross Income from Royalties

F. Gross Royalty

ROYALTIES


6

Year of Assessment



Name

HK-5: COMPUTATION OF STATUTORY INCOME FROM INTEREST / ROYALTIES

43

woK hA

2

36368040700

102

0608089893

(Transfer amount H to item C4 Form BE / C13 Form B)

(Transfer amount E to item C3 Form BE / C12 Form B)

(C + D)

9

E. TOTAL STATUTORY INCOME FROM INTEREST

(Amount from item C Working Sheet HK-6/

D. Total Gross Income from Interest

B. Interest on loan employed in the production

A. Gross Interest

RM

GO

INTEREST

item E Working Sheet HK-8/HK-9)

item D Working Sheet HK-8/HK-9)

naT

LESS:

of gross income from interest

C. Statutory Income (A - B)

5 67


8

No.

No.

(Transfer this amount to item C6 Form BE / C15 Form B)



(Transfer this amount to item G Working Sheet HK-5)

(Transfer this amount to item D Working Sheet HK-5)

9

G. Total gross income from other sources (income code = 8)

F. Total income from trust bodies (income code = 7)

E. Total gross income under section 4A (income code = 6)

D. Total gross income from royalties (income code = 5)

C. Total gross income from interest (income code = 3)

(Z)(Transfer this amount to item E11 Form BE/B)

(Z)

B. Total tax deducted/credit claimed under section 110

6

Year of Assessment



Name

HK-6: TAX DEDUCTION UNDER SECTION 110 (OTHERS)

43

woK hA

2

36368040700

102

060808989

2

3

4

5

6

7

8

9

10

1

TOTAL

Date Of

centsRM

Tax Deducted

Income (RM)

Gross

Trust Body

Name Of Payer/*CodeNo.

(note:-Income Code: 3 = interest, 5 = royalties, 6 = section 4A income,

income from trust bodies such as per CP 30A and other income.payments subject to the provision under section 109B ITA 1967;

A. List out : interest/royalty income subject to the provision under section 109;

3

Receipt

Payment

7 = income from trust body, 8 = other relevant income.)

9GO

naT

00 5474577 200 1,000.00PQR 3 07/08/2012

-

-

-

-

1,000.00

200.00

00 200 1,000.00

(Y)

to a tax refund. Submit this Working Sheet together with documents pertaining to the foreign tax deducted if entitled2.

income was first received or credited.Use the exchange rate provided in Appendix C if there is no other rate of exchange at the time the


1.

H. Total gross income from other sources (income code = 8)

No. 5 6

NOTE:

78964

AGREEMENT WITH MALAYSIA AND CLAIM FOR SECTION 132 TAX RELIEF

3

C. Total gross dividends (income code = 2)

(X)

G. Total income from trust bodies (income code = 7)

Year Of Assessment


I/C No.Tax reference

Name

HK-8: INCOME FROM COUNTRIES WHICH HAVE AVOIDANCE OF DOUBLE TAXATION

F. Total gross income under section 4A (income code = 6)

E. Total gross royalty (income code = 5)

woK hA

2

36368040700

102

TOTAL

060808989

D. Total gross interest (income code = 3)

B. Relief claimed (U or Y whichever is the lower)

U=

Statutory Income

set off or relief

2

3

4

5

6

7

8

9

10

1

Tax chargeable beforeX

Total income from all sources

Total X

No.

(note: *Income code: 1 = business, 2 = dividend, 3 = interest, 5 = royalty, 6 = section 4A income

The relief due is amount Y or amount U, where amount U is computed using the following formula:

A. List of Income

3

Please refer to Public Ruling No. 11/2011 as a guide.

Tax Deducted In TheGross Amount

3.

7 = income from trust body, 8 = other relevant income)

9GO

*CodeForeign Country

naT

160.00 800.002 640.00

-

-

-

-

-

640.00

-

-

800.00 160.00 640.00

to a tax refund. Submit this Working Sheet together with documents pertaining to the foreign tax deducted if entitled2.

income was first received or credited.Use the exchange rate provided in Appendix C if there is no other rate of exchange at the time the


1.

H. Total gross income from other sources (income code = 8)

No. 5 678

NOTE:

9643

(Z)

AGREEMENT WITH MALAYSIA AND CLAIM FOR SECTION 133 TAX RELIEF

Y/2 =

C. Total gross dividends (income code = 2)

G. Total income from trust bodies (income code = 7)

Year Of Assessment


I/C No.Tax reference

Name

HK-9: INCOME FROM COUNTRIES WITHOUT AVOIDANCE OF DOUBLE TAXATION

F. Total gross income under section 4A (income code = 6)

E. Total gross royalty (income code = 5)

woK hA

2

36368040700

102

060808989

D. Total gross interest (income code = 3)

B. Relief claimed (U or Z whichever is the lower)

U=set off or relief

2

3

4

5

6

7

8

9

10

1

TOTAL

Tax Deducted In The

Tax chargeable beforeX

Total income from all sources

Statutory Income

Total X

*CodeNo.

(note: *Income code: 1 = business, 2 = dividend, 3 = interest, 5 = royalty, 6 = section 4A income

The relief due is amount Z or amount U, where amount U is computed using the following formula:

(Y)

A. List of Income

3

(X)

Gross AmountForeign Country

7 = income from trust body, 8 = other relevant income)

9GO

Please refer to Public Ruling No. 11/2011 as a guide.3.

naT

200.00 800.002 1,000.00

1,000.00

-

-

-

-

-

1,000.00

-

-

100.00

200.00 800.00

(Use attachments in case of insufficient writing space)

Deductions (MTD)

Ev

Eiv

Eiii

Eii

i

TOTAL

E. TOTAL (A3 + C + D)

C. Instalments paid in respect of CP 500 or CP 503

DeductionsCP 38 Monthly TaxPeriod Of DeductionEmployer's E No.No.

1

A. Deductions made by the employer in the current year

5


432

Monthly TaxNo. Employer's E No.

Of Income

Year/Period

321

year in respect of previous years' income

B. Monthly Tax Deductions made by the employer in the current

E

5

Year of Assessment



Name

HK-10: INSTALMENTS / SCHEDULAR TAX DEDUCTIONS PAID

ii

woK hA

2

36368040700

102

6

iii

iv

v

Ei

Bil.

E

E

E

E

D. Payments made for the current year other than A, B and C

(RM)(RM)(RM)

0

TOTAL

60808989

Deductions For ZakatDeductions (MTD)

3

78No.

96

9GO

43

naT

200.00 1,000.006879675867 100.002012

6879675867

1,000.00

100.00 200.00 1,000.00

No.

Paid

Amount

LHDNMPaid

Net

(1)(b) only (3%)]

paragraph 107A

Remitted To

Withholding Tax

Remitted To

Withholding TaxGrossDate Of

109B ITA 1967 (SECTION 4A INCOME)

109A ITA 1967 (PUBLIC ENTERTAINERS)

109 ITA 1967 (INTEREST AND ROYALTIES)

107A ITA 1967 (NON-RESIDENT CONTRACTORS)

PROVISION OF SECTION :PAYMENTS MADE IN THE BASIS YEAR TO NON-RESIDENTS UNDER THE WITHHOLDING TAX

Amount

LHDNM [for

Enter “X” in the relevant box. Choose one only. Use separate working sheet for each type of withholding tax.

(Transfer the total amount to item J3a / J3b / J3c / J3d / J3e Form B)

X


Year of Assessment 2102

No.Business Registration No.


Name

HK-11: BASIS YEAR PAYMENTS TO NON-RESIDENTS (WITHHOLDING TAX)

woK hA

36368040700

5 6789643

12

11

10

109D ITA 1967 (INCOME FROM UNIT TRUST)

9

8

TOTAL

7

6

060

Receipt

80

5

89893

No.

4

3

2

9GO

109F ITA 1967 (INCOME FROM SUB-SECTION 4(f))

n

Payment

aT

1 1,000.0002/08/2012 740.005745 - 260.00

1,000.00 740.00- 260.00

Enter "X" in the relevant box.

Use attachment(s) if case of insufficient writing space.

( 1 to 5 )TOTAL

CHILD - DISABLED

( 1 to 5 )TOTAL

5

4

3

Higher Education

( 1 to 10 )TOTAL

CHILD - 18 YEARS OF AGE & ABOVE AND RECEIVING EDUCATION

CHILD - BELOW THE AGE OF 18 YEARS

HK-13: DEDUCTION FOR MAINTENANCE OF UNMARRIED CHILDREN

*

5

4

1

2

1

10

9

Claimed

3

Amount

ReliefRate *

Eligibility

50%100%

Higher Education

Level of Education at the Institution of

Outside MalaysiaIn Malaysia

2

Date Of Birth University / Institution Of

Name Of School / College /

Name Of Child

No.

No.

8

7

6

5

4

3

2

Name

Tax Reference

Year of Assessment

*

1

woK hA

2102

0608089893 GO

naT

1,000 XABC 08/01/2000Tan Ah fatt

1,000

5

Year of Assessment



Name

woK hA

2

36368040700

102

6

060

TOTAL

Year (RM)

Paid In the Current

Premium

Husband / Wife

On Self Or

Policy No. Name Of Insurance Company No.

10

9

8

7

6

10

9

8

7

6

3

4

5

2

Premium Paid In

Contribution /On Own Life Or

Provident Fund No.

Policy No. /Name Of Insurance Company /No.

(1 to 10)

(1 to 10)TOTAL

Or Child

3

4

5

2

808

Wife / Wives

59

9893

78No.

96

9GO

43

naT

1

page -Working Sheet

1

the Current Year (RM)

Life of Husband / Provident And Pension Funds

A: LIFE INSURANCE / PROVIDENT AND PENSION FUND

B: EDUCATION AND MEDICAL INSURANCE

HK-14:

EDUCATION AND MEDICAL INSURANCE

APPROVED PROVIDENT OR PENSION FUNDS,

LIFE INSURANCE PREMIUMS / CONTRIBUTIONS TO

Own AIA 1,00047455567

1,000

with effect from year of assessment 2008)Addendum

08.11.2004Entertainment Expense (refer to Public Ruling No. 3/2008 3/2004 &

19/04/2010

17/04/2009 &

Fourth Addendum

Third Addendum &

17/01/2006,

20/05/2005,

Second Addendum,

08/11/2004,Benefits-In-Kind2/2004 &

Addendum &

30.06.2004Income from Letting of Real Property1/2004

30.12.2003“Key-Man” Insurance2/2003

23/08/2007Addendum

with effect from year of assessment 2010)

Expenses For Companies (refer to Public Ruling No. 2/2010

05/08/2003 &Tax Treatment relating to Leave Passage1/2003 &

05/08/2003Allowable Pre-operational And Pre-commencement of Business 2/2002

02/04/2002 Deduction for Bad & Doubtful Debts and Treatment of Recoveries1/2002

LH : 1/3

30/04/2001Basis Period for Business & Non-Business Source (Companies)7/2001

30/04/2001

Companies/Co-operatives

Basis Period for a Business Source (Individuals & Persons other than6/2001

30/04/2001Basis Period for a Business Source (Co-operatives)5/2001

30/04/2001

(Individuals & Persons other than Companies)

Basis Period for a Non-Business Source4/2001

18/01/2001Appeal against an Assessment3/2001

18/01/2001Computation of Initial & Annual Allowances in respect of Plant &

Machinery

2/2001

Allowances

18/01/2001Ownership of Plant and Machinery for the Purpose of Claiming Capital1/2001

30/12/2000Wilful Evasion of Tax and Related Offences8/2000

16/06/2000Providing Reasonable Facilities and Assistance7/2000

(Revised) (Persons other than Companies or Individuals)

6/2000 30/06/2001Keeping Sufficient Records

01/03/2000

(Persons other than Companies or Individuals)

Keeping Sufficient Records6/2000

(Revised) (Individuals & Partnerships)

30/06/2001Keeping Sufficient Records5/2000

01/03/2000Keeping Sufficient Records (Individuals & Partnerships)5/2000

(Companies and Co-operatives)

30/06/2001Keeping Sufficient Records

(Revised)

4/2000

01/03/20004/2000 Keeping Sufficient Records (Companies and Co-operatives)

Companies/Co-operatives)

01/03/2000Basis Period for a Business Source (Individuals & Persons other than3/2000

2/2000 01/03/2000Basis Period for a Business Source (Companies & Co-operatives)

Basis Period for a Non-Business Source 01/03/20001/2000

NoYesCompliance

UpdatedIssued/Subject of Public RulingNo.

Form B Guidebook

APPENDIX H: DIRECTOR GENERAL'S PUBLIC RULINGS

Self Assessment System

LH : 2/3

10/03/2011Investment Holding Company3/2011

07/02/2011Interest Expense and Interest Restriction2/2011

Overseas

07/02/2011Taxation of Malaysian Employees Seconded 1/2011

prior to year of assessment 2010)

Expenses (Refer to Public Ruling No. 2/2002

03/06/2010Allowable Pre-operational and Pre-commencement of Business 2/2010

19/04/2009Withholding Tax on Income under Paragraph 4(f)1/2010


30/07/2009Professional Indemnity Insurance (Refer to Public Ruling No. 5/20063/2009

(superseded Public Ruling No. 3/2006)

22/05/2009Construction Contracts2/2009

(superseded Public Ruling No. 3/2006)

22/05/2009Property Development1/2009


22/10/2008Entertainment Expenses (Refer to Public Ruling No. 3/20043/2008

03/04/2008Reinvestment Allowance2/2008

27/03/2008Special Allowances For Small Value Assets1/2008

06/07/2006Tax Treatment of Legal and Professional Expenses6/2006

with effect from year of assessment 2008)

31/06/2006Professional Indemnity Insurance (Refer to Public Ruling No. 3/20095/2006

31/05/2006Valuation of Stock in Trade and Work in Progress, Part I4/2006

(superseded by Public Ruling N0. 1/2009 & 2/2009)

13/03/2006Property Development & Construction Contracts3/2006

17/01/2006Tax Borne By Employers2/2006

30/07/2009

25/02/2009 &

30/08/2007,

Third Addendum

Second Addendum &

Addendum &

17/01/2006,Perquisites From Employment1/2006,

01/07/2009Addendum

08/12/2005 &Trade Association6/2005 &

14.11.2005Deduction for Loss of Cash and Treatment of Recoveries5/2005

04/01/2010

30/11/2007 &

Second Addendum

Addendum &

12/09/2005,Withholding Tax on Special Classes of Income4/2005,

05/02/2009Addendum

11/08/2005 &Living Accomodation Benefit Provided for the Employee by the Employer3/2005 &

03/01/2008

06/07/2006 &

Second Addendum

Addendum &

06/06/2005Computation of Income Tax Payable by a Resident Individual2/2005,

05/02/2005Computation of Total Income for Individual1/2005

03/04/2008Addendum

30/12/2004 &Double Deduction Incentive on Research Expenditure5/2004 &

09/12/2004Employee Share Option Scheme Benefit4/2004

NoYesCompliance


Form B Guidebook



(supersedes Public Ruling No. 2/2004 and its Addenda)

15/03/2013Benefits In Kind3/2013

(supersedes Public Ruling No. 1/2006 and its Addenda)

28/02/2013Perquisites from Employment2/2013

04/02/2013Deductions for Promotion of Exports1/2013

24/12/2012Share Scheme Benefit for Cross Border Employees12/2012

(supersedes Public Ruling No. 4/2004)

13/12/2012Employee Share Option Scheme Benefit11/2012

13/12/2012Tax Treatment of Malaysian Ship

26/11/2012Taxation of Real Estate Investment Trusts / Property Trust Funds9/2012

10/2012

02/11/2012Real Estate Investment Trusts / Property Trust Funds - An Overview8/2012

Property Trust Funds

29/10/2012Taxation of Unit Holders of Real Estate Investment Trusts / 7/2012


12/10/2012Reinvestment Allowance 6/2012

25/06/2012Clubs, Associations or Similar Institutions5/2012


01/06/2012Deduction for Loss of Cash and Treatment of Recoveries4/2012

(supersedes Public Ruling No. 3/2001 & its Addendum)

04/05/2012Appeal Against An Assessment3/2012

03/05/2012Foreign Nationals Working In Malaysia - Tax Treaty Relief2/2012

27/01/2012Compensation For Loss Of Employment1/2012

Working for Certain Companies in Malaysia

20/12/2011Tax Exemption on Employment Income of Non-Citizen Individuals12/2011

20/12/2011Bilateral Credit and Unilateral Credit11/2011

05/12/2011Gratuity10/2011

16/11/2011Co-operative Society9/2011

16/11/2011Foreign Nationals Working in Malaysia - Tax Treatment8/2011

Trust Body / Co-Operative Society

23/08/2011Notification Of Change In Accounting Period Of A Company / 7/2011

16/05/2011Residence Status Of Individuals6/2011

16/05/2011Residence Status Of Companies And Bodies Of Persons5/2011

(refer to Public Ruling No. 1/2004 prior to year of assessment 2011)

10/03/2011Income from Letting of Real Property 4/2011

NoYesCompliance


Form B Guidebook



LH : 3/3

................................................................

.,,RM ,

2102/80/1

900704086363

0

0356783456

PUBLIC BANK BERHAD

5757567

00002

Tarikh :

No. Telefon

PembayarNama Bank

Lain-lainNo.Cek dan

PendaftaranNombor

Nama dan Alamat Pos

Amaun Bayaran

2012 1

084

TAHUN TAKSIAN

WP KUALA LUMPUR

KUALA LUMPUR 51200

NO. ANSURANKOD BAYARANNO. RUJUKAN CUKAI

CP 501 [Pin. 1/2012]

Bersama-sama ini disertakan cek/kiriman wang/wang pos/draf bank sebagai bayaran cukai pendapatan.

KETUA PENGARAH HASIL DALAM NEGERI

Kepada:

SLIP PENGIRIMAN BAYARAN

22 Jalan Ipoh

Tan Ah Kow

OG3989808060

0

0

0

0

0

50,000

50,000

7Type of Business

Registration No.

2

HK-PC1

6.

ADD:

LESS:

2.

1.

D.

C.

(Restricted to the amount in item A3)B.

(If loss, enter ‘0’ in this box and transferA.

3

0

8

Year of AssessmentIndicate "X" in the relevant box

Business X

No.

0

0

0

Balance carried forward ( D6 - D7 )8.

Claim absorbed in the current year

LESS:

Tax Reference

Name

HK-PC1 : COMPUTATION OF STATUTORY INCOME FOR BUSINESS

TOTAL ( D3 + D4 + D5 )

5.

Balancing Allowance

change in shareholding (if relevant)

.dhB .ndS woK hA

50,000

0

4.

0219

210

Amount disregarded due to substantial

67

Balance brought forward

ADJUSTMENT OF CAPITAL ALLOWANCE

STATUTORY INCOME ( A3 - B)

96857463 5645

Capital Allowance absorbed

52 62

naT

LESS:

(amount from B)

7.

Capital Allowance

3.

3.

2.

ADD:

the amount of adjusted loss to Working

TOTAL ( A1 + A2 )

Balancing charge

Sheet HK-F1 / HK-F2 whichever is relevant)

Adjusted Business Income

Tour operator activities Business code

1.

TOTAL ( D1 - D2 )

Registration No.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

6796857463 564552 62

C

B

A

HK - C14 : COMPUTATION OF STATUTORY INCOME - DIVIDEND

900

100

1,000

n

Less:

aT

(from Appendix B1, B3, B4)

HK-C14

Gross Dividends

STATUTORY INCOME ( A - B )

in the production of the above dividend income

No.

Interest expended on loan employed exclusively

HK-C15

0

0

0

900

0

900

100

1,000

TOTAL STATUTORY INCOME FROM ROYALTIES ( D + E )

TOTAL GROSS INCOME FROM ROYALTIES

Gross Royalties


F.

TOTAL STATUTORY INCOME FROM INTEREST ( A3 + B )


Registration No.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

C.

67

E.

D.

B.

96857463 5645

TOTAL GROSS INCOME FROM INTEREST

52 62

3.

naT

No.

Less:

A.

2.

Statutory Income

Gross Interest1.

in the production of the above income from interestInterest expended on loan employed exclusively

HK-C15: COMPUTATION OF STATUTORY INCOME-ROYALTY

(xiii)(xii)

(A - B)

D.

C.

Registration no.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

B.

67

(x)(ix)(viii)

9685

7,900

7,900

2,100

0 0 0 0 0 0 0

600

7463 5

500

400 300 200

(xi)

partnership

6

Total statutory income from rental including rental received from

4

Statutory Income

100

5

Total Expenses

10,000

Commission Maintenance and repairs Other revenue expenses:

Insurance Quit Rent

(vii)

52 62

(vi)

Assessment

(v)

(iv)

Interest expense on loan incurred exclusively in the production to the above

Allowable Expenses

LESS:

(iii)

n

(from Attachment B5)GROSS RENTAL INCOME

(ii)

a

(i)

A.

HK-C16

T

No.

HK - C16 : COMPUTATION OF STATUTORY INCOME - RENTAL

Total loss carried forward ( D + J ) 1,000K.

0J. Current year loss not surrendered ( G - H )

0

(if relevant)Group Relief provision

H. Less: Amount surrendered under the

G.

Registration No.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

67

aggregate income of current year

F. Less:

96857463 5645

E.

52 62

(A - B - C )

D.

income of current year

by aggregate statutory business

n

Less:C.

Amount disregarded due toB.

Enter ‘X’ in the relevant box

a

Losses absorbed by

Current year loss

Balance of losses for prior years not absorbed

Losses for prior years absorbed

substantial change in shareholding

Less:

A.

Balance of current year loss not absorbed ( E - F )

No.

XBusiness

T

Balance of losses brought forward

(if relevant)

0

100

0

1,000

0

HK-F1 : ADJUSTMENT OF LOSSES FOR BUSINESS AND PARTNERSHIP

0

1,000

HK-F1 : 1/2

HK - J : INCOME OF PRECEDING YEARS NOT DECLARED

Registration no. 3 8

Tax Reference

Name

. d h B

. n d S

w o K

h A

6 7 9 6 8 5 7 4 6 3 5 6 4 5 5 2 6 2

n a T

No.

HK- J

Tax Repayable Tax Discharged Additional Tax Chargeable Income Assessment Year of

- 200.00 1000 2011 -

Registration no.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

6796857463 564552 62

naT

No.

HK-O : 1/2

No :Yes :( Indicate "X" )

H. Managing Director :

passport no :

Fee/commission/allowance :

Salary/bonus :

Shareholding (%) :

Income Tax no :

Identity card no./

Address :

Name of Director :

G.

F.

E.

D.

C.

B.

A.

( Indicate "X" )H. Managing Director :

passport no :


Salary/bonus :

Shareholding (%) :

Income Tax no :

Identity card no./

Address :

Name of Director :

G.

F.

E.

D.

C.

B.

A.

( Fill this working sheet and keep for future checking )

No :Yes :

HK-O: PARTICULARS ON FIVE COMPANY DIRECTORS

WP KUALA LUMPUR

Taman Biru 60000

900704086363

Taman Two

6,000

60,000

60.00

3989808060

1 Jalan One

Tan Ah Kow

X

Taman Hijau 61000

935263085757

Taman Four

4,000

40,000

40.00

4567577777

2 Jalan Three

Chan Kam Fook

X

WP KUALA LUMPUR

HK-O : 2/2



passport no :


Salary/bonus :

Shareholding (%) :

Income Tax no :

Identity card no./

Address :

Name of Director :

G.

F.

E.

D.

C.

B.



passport no :


Salary/bonus :

Shareholding (%) :

Income Tax no :

( Indicate "X" )H. Managing Director :

passport no :


Identity card no./

Address :

Name of Director :

G.

F.

E.

Salary/bonus :

D.

C.

Shareholding (%) :

Income Tax no :

Identity card no./

Address :

Name of Director :

G.

F.

E.

D.

C.

B.

B.

A.

A.

No :Yes :

A.

Registration no.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

6796857463 564552 62

naT

No.

HK-P : 1/2

Holding through other entities (Number/%) :

Direct Holding (Number/%) :

Country of residence :

Income Tax no :

Address :

Name of Shareholder :

G.

F.

E.

D.

C.

B.

A.

company registration no. :


Identity card no./passport no./




Income Tax no :


Address :


G.

F.

E.

D.

C.

B.

A.

( Fill this working sheet and keep for future checking )

HK-P: INFORMATION ON FIVE MAJOR SHAREHOLDERS OF A CONTROLLED COMPANY

60.00

Taman Biru 60000

900704086363

Taman Two

60,000

MY

3989808060

1 Jalan One

Tan Ah Kow

WP KUALA LUMPUR

Taman Hijau 61000

935263085757

Taman Four

40,000

MY

4567577777

2 Jalan Three

Chan Kam Fook

WP KUALA LUMPUR

40.00

HK-P : 2/2

company registration no. :Identity card no./passport no./

Holding through other entities (Number/%):



Income Tax no :

Address :


G.

F.

E.

D.

C.

B.





Income Tax no :




Address :


G.

F.

E.

Direct holding (Number/%) :

D.

C.


Income Tax no :


Address :


G.

F.

E.

D.

C.

B.

B.

A.

A.

A.

LESS:

LA1 : 1/2

Non-taxable gains/income entered in the profit or loss account:

3.

Non-allowable losses:

ADD:

ADJUSTMENT OF BUSINESS INCOME

TOTAL BUSINESS INCOME (A - B)

TOTAL NON-BUSINESS INCOME

Other incomeInterest incomeRoyalty incomeRental incomeDividend income

SEPARATION OF INCOME BY CLASS

+ -BALANCE AS PER PROFIT AND LOSS ACCOUNT

--

-

--

Registration No.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

6796857463 564552 62

-

4.

Enter ‘X’ in the relevant box

-

54321Business

100,000

-

-

-TOTAL (D1 + D2)

-Surplus recovered expenditure (mining)2.

-

naT

TOTAL

1.

D.

C.

B.

LESS:

A.

7 9Business Code

-

021

No.

Tour operator activities

APPENDIX A1: COMPUTATION OF ADJUSTED INCOME FOR BUSINESS

Type of Business

AmountItem

-

X

--

100,000 -

- 100,000

-

------

-

---

-

-

--------

sheet for the determination of statutory income.

Proceed with the computation by transferring the amount of adjusted income for each business to the working

ADJUSTED INCOME / (LOSS)

3.

2.4

Allowable expenses not entered in the Profit and 2.3

2.

Plant & equipment written off Term Loan Interest (rental source)

TOTAL:

Quit rent & assessment (rental source) Maintenance (rental source)

-

-

Insurance (rental source)

LA1 : 2/2

Depreciation

Non-allowable expenses under subsection 39(1)

Loss Account (extracted from the Balance Sheet):

under subsection 33(2)

Interest expense restricted

5.

F.

TOTAL ( E1 - E2 )

Other expenses/incentive claim (refer to Appendix D):

-Surplus residual expenditure (mining)2.2

-Mining allowance 2.1

LESS:

1.2

1.1

ADD:1.

ADJUSTMENT OF BUSINESS EXPENDITUREE.

--TOTAL ( D3 - D4 + D5 )6.

- - -

Profit and Loss Account but entered in the Balance Sheet:

Taxable gains/income not entered in the

ADD:

Registration No.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

6796857463 5645

15

52 62

naT

Proceed with the computation overleaf if the rate of tax deducted on dividend received as per voucher/ certificate differs from the tax rate for current year of assessmentNote:

14

[Amount from B(ii)]

13

[Amount from B(i)]

EndedFor Year Rate

Tax

Sen Sen

12

11

Total Regrossed

TOTAL NET DIVIDEND

10

9

8

7

6

5

4

3

2

1

Net

Sen

Tax Deducted

RMRM

DividendGross

Name of CompanyPaymentDate of

No.

List of dividend income:

Serial No.

No.

Submit this Working Sheet and original dividend vouchers if entitled to a tax refund

Warrant No./

A.

RM

APPENDIX B1 : TAX DEDUCTION UNDER SECTION 110 OF INCOME TAX ACT 1967 / SECTION 51 OF FINANCE ACT 2007 (DIVIDENDS)

Dividend

LB1 : 1/2

(Y)(X)

80 20ABC 20.0031/12/2012 0000 10057567787 01/08/2012 00

80 00

section 4(a) of ITA 1967.

Working Sheet HK-PC1 / HK-PC9 / HK-PC9A if dividend income is assessed as business income under(ii)

Working Sheet HK-C14 to determine the statutory income; or(i)

Proceed with the computation by transferring amount X to: C.

* Where Z is the current year’s tax rate for corporations.

(Y)=

Z *xX=

(Y)Tax deemed deducted(ii)

(X)=

( 1 - Z * )

1

xNet dividend=

(X)Dividend regrossed(i)

deducted:

corporations, use the following formula to regross the net dividend received and compute the tax deemed

If the rate of tax deducted as per dividend voucher / certificate differs from the current year’s tax rate for

Computation of regrossed dividend and tax deemed deductedB.

Enter the amount of regrossed dividend in column ‘X’ under ‘Gross Dividend’.

Total gross of other income (income code = 8)G.

Total gross income from trust bodies (income code = 7)F.

Total gross section 4A income (income code = 6)E.

Total gross royalty income (income code = 5)D.

Total gross interest income (income code = 3)C.

Total tax deducted/set-off claimed under section 110

(Z)

Sen(RM)Trust Body

other relevant income)=8

2Year of Assessment 210

Registration No.3 8

Tax Reference

Name

.dhB .ndS woK hA

income from trust bodies

67

=7

section 4A income

96857463 5645

=

52 62

na

6business, 2 = dividends, 3 = interest, 5 = royalty,=1

other relevant income.

income from trust bodies as per CP30A

APPENDIX B2: SECTION 110 TAX DEDUCTION (OTHERS)

income listed under section 109B of the same Act;

No.

interest/royalty income pursuant to the provision under section 109 of ITA 1967;List out:

(Note - * Income Code:

RM

No

T

PaymentDate of

DeductedTax

Income

B.

TOTAL

10

9

8

7

6

5

4

3

2

1

ReceiptGrossName of Taxpayer/Code*No.

A.

LB2

536756756 20 100.00 00BCD 2 07/08/2012

00

-

-

20 100.00

-

-

-

20.00

the foreign country.

If entitled to a refund, submit this Appendix together with relevant documents pertaining to the tax deducted in2.

credited is not available.

Use the foreign currency exchange rate provided in Appendix C if the rate as at the time the income is paid or1.

H.

Note:

Total gross of other income (income code = 8)

Total gross income from trust bodies (income code = 7)

COUNTRIES WITH AVOIDANCE OF DOUBLE TAXATION AGREEMENT

LB3

C.

Total gross section 4A income (income code = 6)

G.

(Transfer this amount to Working Sheet HK-C15)Total gross royalty income (income code = 5)

(Transfer this amount to Working Sheet HK-C15)Total gross interest income (income code = 3)

(Transfer this amount to Working Sheet HK-C14)

APPENDIX B3: CLAIM FOR SECTION 132 TAX RELIEF - INCOME FROM COUNTRIES

F.

E.

Relief claimed (U or Y, whichever is lower)

Total gross dividend income (income code = 2)

No claim for section 132 relief is available to Operational Headquarters Company.3.


Registration No. 3 8

Tax Reference

Name

.dhB .ndS woK hA

Income

6796857463

D.

B.

U=before relief

2

3

4

5

6

7

8

9

10

1

Total

Tax Deducted in the

Tax chargeableX

all sources

Total Income from

Gross

Total X

No.

Code *No.

(Note - * Income Code: 1 = business, 2 = dividends, 3 = interest, 5 = royalty, 6 = section 4A income

Relief due is either amount Y or amount U, where amount U is computed using the following formula:

(Y)

A.

5645

(X)

Statutory

5

Foreign Country

7 = income from trust bodies, 8 = other relevant income)

2 62

na

Income

Details of Income

T

20.00 80.002 100.00

-

-

-

-

-

100.00

-

-

20.00 80.00

the foreign country.

If entitled to a refund, submit this Appendix together with relevant documents pertaining to the tax deducted in2.

credited is not available.

Use the foreign currency exchange rate provided in Appendix C if the rate as at the time the income is paid or1.

H.

Note:

(Z)

WITHOUT AVOIDANCE OF DOUBLE TAXATION AGREEMENT

Y/2 =

C.

G.

Total gross of other income (income code = 8)

Total gross income from trust bodies (income code = 7)

Total gross section 4A income (income code = 6)(Transfer this amount to Working Sheet HK-C15)Total gross royalty income (income code = 5)

APPENDIX B4: CLAIM FOR SECTION 133 TAX RELIEF - INCOME FROM COUNTRIES

F.

E. (Transfer this amount to Working Sheet HK-C15)Total gross interest income (income code = 3)

LB4

No claim for section 133 relief is available to Operational Headquarters Company.3.


Registration No. 3 8

Tax Reference

Name

.dhB .ndS woK hA

(Transfer this amount to Working Sheet HK-C14)

6796857463

D.

B.

U=before relief

2

3

4

5

6

7

8

9

10

1

Total

Tax Deducted in the

Tax chargeableX

all sources

Total Income from

Gross Income

Total X

Total gross dividend income (income code = 2)

Code *No.

(Note - * Income Code: 1 = business, 2 = dividends, 3 = interest, 5 = royalty, 6 = section 4A income

Relief due is either amount Z or amount U, where amount U is computed using the following formula:

(Y)

A.

5645

(X)

Relief claimed (U or Z, whichever is lower)

5

Foreign Country

7 = income from trust bodies 8 = other relevant income)

2 62

na

Details of Income

No.

T

20.00 100.002

-

-

-

-

-

100.00

-

-

10.00

20.00 100.00

Registration No.

2

3 8

Year of Assessment

Tax Reference

Name

.dhB .ndS woK hA

210

6796857463 564552 62

Commencement of Payments received in theProperty/Asset

Address of the Property/

n

Year of Assessment (RM)the Rental / Lease

Total Gross Rental / LeaseDate of

APPENDIX B5: PARTICULARS OF PROPERTIES / ASSETS AND TOTAL RENTAL

a

No.Type of

Lessor of the Asset

LIST OF PROPERTIES RENTED OUT / ASSETS LEASED OUTA.

No.

T

KL

61000

Taman Seven 1,00002/08/20125, Jalan Six Apartment 1

LB5

1,000

subsection 4(a) of ITA 1967.

(ii) Working Sheet HK-PC1 / HK-PC9 / HK-PC9A if the rental income is assessed as business income under

(i) Working Sheet HK-C16 to determine the statutory income; or

Proceed with the computation by transferring the total gross amount to:

TOTAL GROSS

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